Cirujano General

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >Cirujano General >Year 2007, Issue 1

Quezada-Adame I, Medina-Villaseñor EA, Fernández-Garza MC, Cabrera-Albarrán A, Balice-Olguín O, Avilés-Tlalpan MP
Amebic peritonitis due to hepatic abscese rupture
Cir Gen 2007; 29 (1)

Language: Español
References: 34
Page: 17-21
PDF: 4. Kb.

Full text


Objective: To describe the surgical experience in cases of peritonitis due to rupture of an amebic liver abscess.
Setting: General Hospital of Atizapán, “Dr Salvador González Herrerón”, ISEM.
Design: Retrospective, transversal, descriptive study.
Statistical analysis: Percentages as summary measure for qualitative variables.
Material and methods: We reviewed the clinical records of patients subjected to surgery due to an amebic liver abscess in a 10-year period. Analyzed variables were: age, gender, indication for surgery, location of the abscess, extension, type of used treatment, morbidity and mortality.
Results: Of 76 patients with amebic liver abscess, 28 (35%) required surgical drainage due to imminent rupture or lack of response to medical treatment; eight (10%) presented free interperitoneal rupture and diffuse secondary peritonitis; one patient (1.2%) presented rupture that extended to the pleura. Rupture predominated in men with an average age of 38 years; the most common location of the abscess was in the right lobe; peritonitis was the most frequent indication for surgery. In all surgical cases, the abscess was aspired, the cavity irrigated, drainage was applied, and treatment consisted of metronidazole and third generation cephalosporin, or dehydroemetine. One patient (1.2%) died due to extension to the pleura and empyema.
Conclusions: Laparotomy must be performed in patients with abscess rupture. The general treatment principles applied to intraabdominal infections must be used with the administration of metronidazole and third generation cephalosporin.

Key words: Amebic liver abscess, amebic peritonitis, surgical treatment.


  1. Hoffner RJ, Kilaghbian T, Esekogwu VI, Henderson SO. Common presentations of amebic liver abscess. Ann Emerg Med 1999; 34: 351-355.

  2. Krige JE, Beckingham IJ. ABC of diseases of liver, pancreas, and biliary system. BMJ 2001; 322: 537-540.

  3. Salles JM, Moraes LA, Salles MC. Hepatic amebiasis. Braz J Infect Dis 2003; 7: 96-110.

  4. Escandón RC, García MNT, Escobedo PJ, Hernández RJM, Olvera AJ, et al. La amibiasis y el absceso hepático amibiano en México, un problema de salud pública de actualidad. Rev Gastroenterol Mex 1996; 61: 378-386.

  5. Caballero-Salcedo A, Viveros-Rogel M, Salvatierra B, Tapia-Conyer R, Sepúlveda-Amor J, Gutiérrez G, et al. Seroepidemiology of amebiasis in Mexico. Am J Trop Med Hyg 1994; 50: 412-9.

  6. Frey CF, Zhu Y, Suzuki M, Isaji S. Liver abscesses. Surg Clin North Am 1989; 69: 259-71.

  7. Essomba A, Chichom Mefire A, Fokou M, Ouassouo P, Masso Misse P, et al. Acute abdomens of parasitic origin: retrospective analysis of 135 cases. Ann Chir 2006; 131: 194-197.

  8. Ralls PW, Colleti PM, Quinn MF, Halls J. Sonographic findings in hepatic amebic abscess. Radiology 1982; 145: 123-126.

  9. Donovan AJ, Yellin AE, Ralls PW. Hepatic abscess. World J Surg 1991; 15: 162-169.

  10. Valadéz GME, Martinez LH, Guerra FCR, Aguilar RJR. Absceso hepático amibiano. Experiencia en los últimos cinco años en el Hospital Central Militar. Rev Sanid Milit 2000; 54: 145-47.

  11. Eggleston FC, Handa AK, Verghese M. Amebic peritonitis secondary to amebic liver abscess. Surgery 1982; 91: 46-48.

  12. Basile JA, Klein SR, Worthen NJ, Wilson SE, Hiatt JJ. Amebic liver abscess. The surgeon’s role in management. Am J Surg 1983; 146: 67-71.

  13. Meng XY, Wu JX. Perforated amebic liver abscess: clinical analysis of 110 cases. South Med J 1994; 87: 985-90.

  14. Mier y Diaz J, Blanco-Benavides R, Medina-González E, Sigler-Morales L, Melgoza-Ortiz C. Surgical treatment of amebic liver abscess. Arch Invest Med (Mex) 1990; 21suppl 1: 123-5.

  15. Holcombe C. Surgical emergencies in tropical gastroenterology. Gut 1995; 36: 9-11.

  16. Tay KH, Ravintharan T, Hoe MN, See AC, Chng HC. Laparoscopic drainage of liver abscesses. Br J Surg 1998; 85: 330-2.

  17. Akgun Y, Tacyildiz IH, Celik Y. Amebic liver abscess: changing trends over 20 years. World J Surg 1999; 23: 102-6.

  18. Mogollon PA, Molina SG, Martínez MF, Sánchez VP, Sánchez TS, Dávila FBC, et al. Percutaneous drainage of amebic hepatic abscess by guided ultrasound. Preliminary results. Rev Gastroenterol Mex 1999; 64: 134-8.

  19. Wells CD, Arguedas M. Amebic liver abscess. South Med J 2004; 97: 673-682.

  20. Fujihara T, Nagai Y, Kubo T, Seki S, Satake K. Amebic liver abscess. J Gastroenterol 1996; 31: 659-663.

  21. McGarr PL, Madiba TE, Thomson SR, Corr P. Amoebic liver abscess-results of a conservative management policy. S Afr Med J 2003; 93: 132-6.

  22. Djossou F, Malvy D, Tamboura M, Beylot J, Lamoulitte H, Longy-Boursier M, et al. Amoebic liver abscess. Study of 20 cases with literature review. Rev Med Interne 2003; 24: 97-106.

  23. Blessmann J, Binh HD, Hung DM, Tannich E. Treatment of amoebic liver abscess with metronidazole alone or in combination with ultrasound-guided needle aspiration: a comparative, prospective and randomized study. Trop Med Int Health 2003; 8: 1030-1034.

  24. Lo RH, Yu SC, Kan PS. Percutaneous needle aspiration in the treatment of hepatic abscess: factors influencing patients’ outcome. Ann Acad Med Singapore 1998; 27: 173-7.

  25. Rodríguez MA. Absceso amibiano del hígado. Tratamiento médico con diferentes esquemas. Rev Hosp Jua Mex 2000; 67: 51-54.

  26. Wallace RJ Jr, Greenberg SB, Lau JM, Kalchoff WP, Mangold DE, Martin R. Amebic peritonitis following rupture of an amebic liver abscess. Successful treatment of two patients. Arch Surg 1978; 113: 322-325.

  27. Bukhari AJ. Ruptured amebic liver abscess. J Coll Physicians Surg Pak 2003; 13: 159-60.

  28. Ken JG, vanSonnenberg E, Casola G, Christensen R, Polansky AM. Perforated amebic liver abscesses: successful percutaneous treatment. Radiology 1989; 170: 195-197.

  29. Sarda AK, Bal S, Sharma AK, Kapur MM. Intraperitoneal rupture of amoebic liver abscess. Br J Surg 1989; 76: 202-203.

  30. Greaney GC, Reynolds TB, Donovan AJ. Ruptured amebic liver abscess. Arch Surg 1985; 120: 555-61.

  31. Stanley SL Jr. Amoebiasis. Lancet 2003; 361: 1025-34.

  32. Sharma MP, Ahuja V. Management of amebic liver abscess. Arch Med Res 2000; 31: S4-S5.

  33. Dalvi AN, Gondhalekar RA, Upadhye AS. Post-operative irrigation in the management of amoebic peritonitis. J Postgrad Med 1987; 33: 61-4.

  34. Chao TH, Li YH, Tsai LM, Tsai WC, Teng JK, Lim LJ, et al. Amebic liver abscess complicated with cardiac tamponade and mediastinal abscess. J Formos Med Assoc 1998; 97: 214-6.

>Journals >Cirujano General >Year 2007, Issue 1

· Journal Index 
· Links 

Copyright 2019